In a recent publication in the Journal of Clinical Oncology, Braiteh and colleagues describe the treatment of a 35-year-old white man who had suffered from psoriasis vulgaris and psoriatic arthropathy for 15 years before being diagnosed with multiple myeloma. Approximately 4 months after his initial treatment for the multiple myeloma, his disease relapsed. The patient was then treated with hematopoietic stem cells.
Before the stem cell treatment, the psoriasis plaques covered half of the patient’s body, with most of its coverage on the scalp, forehead, chest, abdomen, back, and ears. His elbows, knees, and nails were also affected. Following the treatment, the patient had a full year of remission of his myeloma and a complete regression of his psoriatic arthropathy and skin lesions. He was able to maintain this progress even without corticosteroids and phototherapy.
At the time of this publication, 15 months after his treatment, his myeloma had relapsed, but he was still psoriasis free and arthralgia free. These results demonstrate the possibility that hematopoietic stem cells could be an effective treatment option for patients suffering from psoriasis. Indeed, treatments with these types of stem cells have shown positive therapeutic effects in psoriasis and other autoimmune diseases, such as rheumatoid arthritis, multiple sclerosis, scleroderma, and systemic lupus erythematosus.
One reason it is thought that hematopoietic stem cells may help treat autoimmune disorders like psoriasis is that these cells may help the immune system to reduce its autoimmune activity. In autoimmune disorders, the immune system begins attacking one’s own body when it mistakes parts of the body as foreign and threatening. While this type of action by the immune system is favorable when the body has harmful foreign invaders like bacteria, it is problematic when the immune system mistakes innocuous stimuli as dangerous. Treatments that enable the immune system to recognize that non-threatening stimuli are safe or that they can reduce the negative reaction to the immune system as a result to these stimuli can be valuable when approaching autoimmune disorders.
With a better understanding of what stem cells can do to help these specific patient populations, it will be easier to develop treatment options that have a long term positive impact on individual patients.
St. Petersburg, Florida
